Additional GVS advice nirmatrelvir/ritonavir (Paxlovid®) for the treatment of COVID-19
In November 2022, nirmatrelvir/ritonavir (Paxlovid) was included in the Medicines Reimbursement System (GVS), following the advisory report of the National Health Care Institute. This means that this medicinal product is reimbursed from the basic health care package. Paxlovid can be used for treating COVID-19 in adults who do not require supplemental oxygen and who have a very high risk of the disease becoming severe. Due to the desire for the rapid availability of the product, the National Health Care Institute in 2022 granted a provisional exemption for the cost-effectiveness analysis. That exemption will be extended until 1 January 2024. The National Health Care Institute will then reassess the medicinal product. It currently advises the Minister of Health, Welfare and Sport (VWS) to keep Paxlovid in the GVS under the current conditions.
Coronavirus infection
In the previous advice, the National Health Care Institute concluded that nirmatrelvir/ritonavir has added value in the treatment of adults with coronavirus infection (COVID-19) who do not require oxygen supplementation and are at a very high risk of severe disease progress. They must start the 5-day treatment as soon as possible after the coronavirus has been detected, and in any case within 5 days after the onset of symptoms.
In June 2023, the number of infections with COVID-19 decreased significantly and thus, the number of claims for Paxlovid. The numbers are so much lower than expected, so it is unnecessary to carry out a cost-effectiveness analysis at this time.
Assessment postponed until 1 January 2024
The GVS advisory report of 27 October 2022 stated that the National Health Care Institute would evaluate the need for a pharmacotherapeutic reassessment of nirmatrelvir/ritonavir after 1 year. The National Health Care Institute is postponing this evaluation until January 2024 due to the current situation around COVID-19 and the low number of claims for this medicinal product. The National Health Care Institute thus extends the provisional exemption for a pharmaco-economic analysis until 1 January 2024.
Recommendations from the National Health Care Institute
The National Health Care Institute advises the Minister of VWS to maintain nirmatrelvir/ritonavir in the GVS under the current conditions.